Of the fifty three women, full psychiatric diagnoses were obtained for forty six. The other seven patients had MMPI diagnoses, but they had not remained in treatment long enough for a thoroughgoing diagnosis to be established. Most of the diagnoses resulted from a consensus opinion of our clinic staff. There were some cases, however, in which a patient's diagnosis represents my reinterpretation of the clinical material. This was necessitated because some primary therapists who had initially refused to diagnose a patient for fear of their being stigmatized, eventually "diagnosed" her as "normal;" provided that she did not reveal any overt psychosis or bizarre behavior (apart from a wish for sex reassignment). While I could not accept such a labeling schema, my eventual diagnostic label was, in most cases, closer to the results of psychological testing than to those of clinical interviewing. Table 4.1 summarizes these findings. Using my schema, about 40 per cent of the patients were diagnosed as either psychotic, borderline, or schizophrenic.

Clearly, it would be beneficial if we could reconstruct a composite picture of the average female transsexual. The data, however, suggest that female transsexualism is the outcome of many different converging paths, no single one of which can be isolated and depicted as the essence of female transsexualism. On the other hand, what emerges is anything but a "stable" picture of those fem ales who identify as transsexuals. Indeed, we are presented with a picture of family life in which disorganization, chaos, and overstimulation were common occurrences. Some of these families exhibited outright violence, engaging in child abuse and incest. A majority of the women described their early childhoods as characterized by themes of abandonment, loss, separation, and death. Most of the women had little love for their parents (though there were exceptions); were generally depressed, and experienced considerable emotional turmoil and severe personality disturbances. Many of them also seemed to have chronic adjustment problems, and almost 40 per cent could be described by any standards -- as having profound psychological distress.

Psychological testing diagnoses of 53 female transsexuals

A group psychological profile never gives us the necessary details to identify any single member. For this reason it is imperative to look closely at the lives of individual women who grew up to identify as female transsexuals. What problems did they face? What patterns emerged which might shed light on the etiology of their disorder? It is hoped that the following case histories will provide answers to some of these questions. The cases are presented in order to provide a more intensive view of how a variety of women, throughout their life cycles, choose a certain kind of gender adaptation to their chronic gender dysphoria. While all' of the cases have been altered to protect the identities of the patients, nothing of significance has been omitted which would alter one's understanding of these cases.